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| August 4, 2006
Sniffing out cancer BY JORDAN E. ROSENFELD
Titled “Diagnostic Accuracy of Canine Scent Detection in Early- and Late-stage Lung and Breast Cancers,” the article—the result of a three-year-long clinical trial—was published in the March issue of the medical journal Integrative Cancer Therapies. It’s no secret that dogs have a powerful sense of smell, but the results of Pine Street’s study show that the dog is in fact the most sensitive “tool” in existence for scent detection of cancer. “Recent research suggests that dogs can detect scent in the measure of one part per trillion,” says Nicholas Broffman, executive director of the nonprofit foundation, the research arm of the clinic, about the unique ability dogs have to identify a single smell out of many. “Pine Street is all about giving people hope,” says Nicholas. “Because of the foundation’s cancer research and the clinic’s work with cancer patients, that is what we’ve turned into a specialty. So how do you give cancer patients hope? Early detection, because the earlier you detect it, the more options you have, anxiety is less and treatment options are better. So we asked ourselves, how can you catch cancer even earlier?” The answer had been lurking in the form of anecdotal studies done with dogs reported in a British journal in the late ’80s, which had never been followed up on. Pine Street then contracted Polish scientist Tadeusz Jezierski—who had conducted research on dogs’ scent detection—and acquired grant funding. “We wondered if there was a bio-marker, some kind of signature to cancer cells,” says Nicholas. “We set out to look for a device to test for such a thing, and it turns out that it is the dog. There is no technology that even comes close.” The double-blind study revealed that cancer cells do indeed seem to convey a kind of scent signature into one’s breath, possibly a chemical result of the actual decay of cells, which can be detected before tumors are found by current scanning equipment such as chest x-rays and CAT scans. The trial involved five dogs: three Labrador retrievers and two Portuguese water dogs, chosen from private owners and Guide Dogs for the Blind. Cancer patients were recruited from various local medical centers in Marin and San Francisco. Cancer patients breathed into special “vapor sampling tubes” filled with silicone oil-coated polypropylene wool that captures “volatile organic compounds” exhaled in the breath as it passes through the tube. The training method for the dogs was a reward-based approach involving delivery of snacks for correct answers. During the trials, when a dog scented cancer, it would indicate a correct response by lying or sitting down in front of the sample station containing a cancer sample. The results of the study are stunning, with accuracy ranging from 77 to 99 percent, depending on the type of cancer. “Our dogs were able to differentiate the breath of people with cancer from those without definitively,” says Nicholas. “And for lung cancer, they had 99 percent accuracy. By no means is this the last word, but there is something to the idea that cancer has a scent.” One of the problems that they are hoping to work on in the follow-up study is to see if they can differentiate kinds of cancers. “Right now our dogs are just saying, ‘cancer—yes or no.’ If a dog smelled you and said you had cancer, you’d like to know where,” says Nicholas. “You can’t have dogs in hospitals. So the next phase is trying to identify what it is in the breath that the dogs smell.” The research results have garnered Pine Street a lot of media attention in publications as prestigious as The New York Times and on television shows like 60 Minutes and the Today Show. “There are people from New York to Florida to Hawaii who are now aware of us,” says Nicholas. “That’s a dramatic shift because in 1982 nobody outside the county had heard of us.” Though the study has changed Pine Street in terms of visibility, it hasn’t changed the way they run things. Pine Street Clinic opened 26 years ago with an emphasis on integrative Chinese medicine and other “alternative” therapies (such as yoga and meditation). They opened the nonprofit foundation in 1989 as a mechanism for obtaining research grants. All the research directly benefits the work being done in the clinic. “On some level the clinic is really unchanged; it looks virtually the same. Same golden light, same small staff and great laid-back vibe,” says Nicholas. Founder and director Michael Broffman—Nicholas’s father—says that of the 260 clients he sees in his Chinese medical practice each month, about 50 percent of them are treated “pretty much for free.” He goes on to say, “About 25 percent of my practice is subsidizing the entire practice.” Both men agree that what has changed over the years is that the amount and quality of their research has increased. “We’ve been involved in cancer research for a long time prior to this study, but for the field in general we’re now taking traditional Chinese medicine from the way most people think of it—as folk medicine—to an evidence-based level by applying scientific techniques,” says Michael. “We do a lot of homework, we read everything, subscribe to hundreds of journals, and are up-to-date on the latest information,” says Nicholas. “You do your patients a disservice if you don’t know. We’ve innovated by being informed; we’re always trying to look into the latest techniques.” As evidence of this, Pine Street’s research director Michael McCulloch is currently in China investigating a new technique that uses non-surgical ultrasound waves to destroy tumors. Soon, they’ll be focusing on ways to treat the more aggressive cancers such as ovarian and pancreatic. “The dog study has had an interesting effect. We’re just a mom and pop organization but we’re pulling off the kinds of studies you’d associate with a large institution,” says Michael. “Rather than having gigantic overhead, we’re able to contract and subcontract with specialists.” The nonprofit foundation allows them to apply for grants and sponsor research and projects they feel are important. One of the first projects the foundation took on in the late 1980s, which the Broffmans would like to update, was to design a pulse-diagnosis machine. Chinese medicine relies heavily upon individual pulse patterns to determine diagnoses. Using simple MS-Dos software, they digitized pulse patterns with specially made electronic transducers that provide a physical image on a computer screen. What has Michael the most excited at the moment, however, only loosely relates to Chinese medicine. “There is a lot of historical evidence that the Chinese may have circumnavigated the globe 150 years before Magellan and that they were here in the Bay Area long before him. South of Chico a farmer digging a well in the late 1920s found a Chinese ship. That ship is now on private land. We did some core drilling samples in ’99 and brought up pottery, seeds and wood pieces and had it analyzed.” The wood pieces, it turns out, are from a tree that is indigenous to China, and the pottery is from Northern China, though it is not yet determined whether it is from 1400, or from the 1850 Gold Rush. “We’d like to be called in to look at any organic materials. Our interest is in any herbs or medicines or acupuncture equipment.” Michael’s goal is to continue to legitimize Chinese medicine through research and publishing. “When we got here in ’79 there were only three practitioners of Chinese medicine in the county, now there are about 140,” he says. “It has been terrific to see it grow. The community has been very good to us, even the physician community.” “To keep doing the good work we do comes down to funding,” says Nicholas. “The more funding we have, the more research we can do.” To learn more about the foundation’s research, log on to www.pinestreetfoundation.org PHOTO BY ROBERT VENTE: Can snuffling snuff out cancer? Nicholas Broffman, at top, with his first and second opinions. |
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The cliché that dogs are “man’s best friend” has received powerful validation of a scientific nature with the recent publication of a study by the San Anselmo-based Pine Street Clinic and Foundation.  |
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